Main Menu

Ophthalmologydown arrow

Home > Disclaimer > Ophthalmology


Ophthalmology for the Oncologist





Causes include:

Orbital cellulitis

  • Commonest cause of proptosis in a child
  • Especially to be considered in immunocompromised child
  • Proptosis
  • Limitation of eye movements
  • +/- optic nerve dysfunction (RAPD / decr. vision / colour vision)


Differentiating features to orbital tumour

  • Pyrexia / unwell systemically
  • Pain (intense)
  • Deep bluish-red hue

 Orbital tumour

  • Can be rapid and dramatic, but less painful and no pyrexia
  • Rhabdomyosarcoma is the most common
  • Other causes include:
    • Optic nerve glioma
    • Meningioma
    • ALL
    • Metastases
    • Orbital Capillary Hemiangioma
    • Medulloblastoma
    • Langerhans cell histiocytosis
    • Ewing sarcoma.



Clinical Tip :


Differentiating orbital cellulitis from preseptal cellulitis.

  • Deeper bluish hue
  • Systemically unwell often with pyrexia
  • Proptosis
  • Limitation of eye movement
  • Optic nerve dysfunction (decreased vision, colour vision or RAPD)  



Clinical Tip :


If the pain seems less than expected for the degree of proptosis, there is a lack of systemic illness and lack of response to intravenous antibiotics then consider imaging to rule out an orbital tumour.


The photograph below shows right proptosis with displacement of the globe down and medially by an orbital tumour

Below is a CT scan of the same child showing proptosis of the right eye by orbital tumour



Back to top